TORONTO – The Canadian Pharmacists Association is about to launch an online version of the resources health-care providers use to prescribe medications, a portal-based service the organization hopes will one day be integrated with electronic patient record systems.
An official unveiling of the service, e-Therapeutics, took place at an e-health conference in Victoria.
Paid for in part by Health Canada’s $800-million primary health-care transition fund, e-Therapeutics was described as a set of decision-support tools for managing medical conditions at the point of care. Much of the content draws from a book the Canadian Pharmacists Association (CPhA) publishes called Therapeutic Choices, but it will also include drug monographs and drug safety notices from Health Canada, adverse reaction reports and formulary information.
The CPhA began working on e-Therapeutics more than two years ago, piloting it with selected health-care practitioners last year. The system is built on IBM’s WebSphere Portal Server, DB2m LDAP and HTTP Server. It will also make use of WebSphere Everyplace, which will allow access on Palm of Pocket PC devices.
Pharmacists or physicians who pay an annual subscription fee ($389 for an individual registration) will be able to export information, such as chapters from Therapeutic Choices that pertain to a particular patient, and correlate that with that patient’s e-health record, said Janet Cooper, the CPhA’s senior director of professional affairs. For now, however, it is still basically a standalone system.
“Eventually, we would like to see that integration with e-prescribing systems, but they’re not even being used yet. That’s not really happening in Canada,” she said. “Those applications are being built right now.”
The content inside e-Therapeutics is vast, Cooper said, offering information on everything from bronchitis to bed-wetting. This includes specific guidelines for the dosage and costs of a drug.
It also includes a drug interaction checker to help prevent any adverse side effects. “We want to make sure there’s no second-guessing (regarding prescribing medication),” she said, pointing to the tool’s slogan, “What Works, When.”
Ajit Ghai, senior director of IT and production services at the CPhA, said the content of e-Therapeutics is written in XML, which means it should be possible to develop Web services that would hook into various electronic patient records as health-care providers and patients demand it.
“Everyone uses this word integration, but it depends on what you mean,” he said. Privacy issues are still of critical importance in health-care. “No individual patient record is going to reside with us. Rather, we would be providing these applications with current evidenced-based therapeutic and drug information as part of the overall management for the patient.”
The blue bible
Even if the integration with patient record systems doesn’t happen for a while, there is still great value in digitizing the content of the CPhA’s resources, said Dr. John Maxted, associate executive director of the College of Family Physicians of Canada. Maxted was among the users in the pilot of e-Therapeutics.
“(Therapeutic Choices) is considered the blue bible for many physicians,” he said. “I used this a couple of times myself just last evening, and it’s a lot better than thumbing through millions of pages, which is what the book is starting to become.”
Neil Stuart, practice leader within IBM Canada’s health-care consulting group, said there were significant challenges in the architecture and design of e-Therapeutics, and stressed that usability was paramount given the need to quickly access information about drug compatibility and side effects.
“It’s dealing with the gap between what we know and what we do in practice,” he said.
The CPhA is aiming e-Therapeutics at pharmaceutical chains as much as it is physicians, said Jeff Poston, the organization’s executive director. These firms have already IT-enabled many of their business processes and should be receptive to the idea, he added.
“The emphasis is very much on supporting decisions,” he said. “It’s issues around managing conditions and getting the right drug at the right time.”